Provider Demographics
NPI:1427823574
Name:ASPEN HEALTH CARE STAFFING LLC
Entity type:Organization
Organization Name:ASPEN HEALTH CARE STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:IJEOMA
Authorized Official - Last Name:IKWUAKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-342-7208
Mailing Address - Street 1:22 RANDOLPH PL
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07108-1208
Mailing Address - Country:US
Mailing Address - Phone:973-342-7208
Mailing Address - Fax:
Practice Address - Street 1:22 RANDOLPH PL
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07108-1208
Practice Address - Country:US
Practice Address - Phone:973-342-7208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Single Specialty